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Radioactive Materials Branch
Forms & Publications

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This section of the website offers a "one stop" look at most of the forms and publications on the Radioactive Materials Section portion of the website.  If you have any questions on completing these forms, please contact a member of the Radioactive Materials Branch Staff for assistance.  Any new or updated forms or publications will have the (Information on ordering Regulations) symbol next to them.

NOTE:   Most of the PDF () forms on this page are "editable."  You can save the form to your local disk and enter information into the form.  However, you WILL NOT be able to save the information typed into the form.  This is a function of Adobe Reader, and not a security setting from DRP.  With the Word97 () Documents, you will be able to save the form, make entries and save those entries.

NOTE:  Look in the "Specific Licensing Section" for licensing guides and additional information which MUST be submitted with New License or Renewal Applications

 
Description of Form / Publication File Format(s)
FORMS
Application for Radioactive Materials License §(see below)
Application for Accelerator License §(see below)
Application for Amendment Form
Preceptor Statement (Supplement A) for Medical Licenses §(see below)
New !  Medical Event Reporting Form  (EFFECTIVE March 01, 2008)  
New !  Dose to an Embryo/Fetus or Nursing Child Reporting Form (EFFECTIVE March 01, 2008)  
Certificate of Disposition of Radioactive Materials (for termination/decommissioning)
Financial Assurance Worksheet (UNDER CONSTRUCTION )
Radiographic and Reciprocity Location report
Memorandum to All Licensees §(see below)
Guidance on Change of Control of Ownership
Occupational Dose Record for a Monitoring Period
Guidance on Adding Board Certified Physician Authorized Users
Notice to Employees (PDF ONLY - 8½" x 14" landscape format)
Notice to Employees (EN ESPAÑOL)  (PDF ONLY - 8½" x 14" landscape format)
New ! 2010 Low Level Radioactive Waste Survey Form    

PUBLICATIONS

NRC Regulatory Guide 8.39 "Release of Patients Administered Radioactive Materials"  

DOT EXEMPTIONS

DOT - SP 11406 Exemption Instructions
DOT - SP 11406 Form  
DOT- SP 10656 Exemption Instructions  
DOT -SP 10656 Form
§NOTE:  Look in the "Specific Licensing Section" for licensing guides and additional information which MUST be submitted with New License or Renewal Applications
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Last Modified :08 October 2013
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